GI Motility Disorders Unit

Treatment opinions for constipation include medication, lifestyle changes, biofeedback, and surgery.

Medication

Fibre supplement such as fybogel may promote frequent bowel movement. In addition, suppositories or mini enemas may also help to regularise the bowels. Laxatives can also provide short term relief, it is common for patients to come to clinic and say "I tried this laxative and it worked well at the beginning but then it stopped working." Then they try another laxative and another and another. However, long term laxative use will make the bowel less and less responsive.

Lifestyle changes

Dietary increase of fibre (daily recommended intake 30 grams) and water (at least 2L of fluid per day), regular exercise through walking or continuous movement and correct sitting position while on the toilet can promote regular bowel.

The correct sitting position on the toilet gives you the best angle to relax your muscles and do a complete motion. Simple rules to follow are feet on stool with knees higher than hips, lean forwards, keeping your back straight, and elbows on knees.

Biofeedback

This is a bowel retraining program run by therapists who are usually specialist nurses or physiotherapists. Usually it involves exercises to retrain muscles and nerves to coordinate and produce a satisfactory effort to empty the bowel.

Surgery

This is only required in a very small minority of patients, usually those with anatomical problems, such as women who have a rectocoele may need surgery. The removal of all or part of the colon to improve bowel function often has a poor result, approximately 10% of patients who have part of the colon removed will end up with a stoma (where the bowel is brought out to the skin, and bowel contents is discharged into a regularly changed bag, rather than through the back passage.).

This stoma is introduced because of incapacitating symptoms or as a result of the failure of previous surgery. Only a minority of patients have been found to have satisfactory health 5 years after such an operation.